酒精性股骨头缺血性坏死脂类代谢异常的临床与实验研究

目的:探讨酒精性股骨头缺血性坏死与脂类代谢的关系。方法:动物实验取新西兰兔45只,随机分成2组,实验组用酒精灌胃诱导骨坏死模型,对照组用生理盐水灌胃。2组动物分批处死。分别行血清学检查和肝脏、股骨头组织学检查。临床研究:酒精性股骨头坏死病人统计血脂变化与同期非骨坏死病人对比进行统计学分析。结果:动物实验:(1)血清学变化:实验组GGT、AST第3个月末,ALT第6个月末升高。与对照组相比差异有显著性(P<0.05)。实验组TG第2个月、CHO第3个月开始出现升高,2组结果差异有显著性(P<0.05)。(2)组织学变化:3个月时实验组肝脏脂肪变性。股骨头骨髓内出现脂肪物质增多,脂肪细胞增大(P<0.05)。骨细胞脂肪变性,空骨陷窝计数升高。临床研究:酒精性骨坏死组甘油三酯含量高于对照组。结论:酒精诱导的早期股骨头缺血性坏死动物模型与非创伤性骨坏死病人均存在血脂代谢紊乱,可导致股骨头缺血性坏死。

Experimental and Clinical Study on Lipid Metabolism of Alcohol-Related Osteonecrosis of Femoral Head

Objective: To ascertain the relationship between osteonecrosis and lipid metabolism. Method: On experimental study: In this study, rabbits were randomly divided into experimental group and control group. By pouripg a high dose of strong wine into stomach,an alcohol-induced ANFH model was produced. The animals from each group were sacrificed in batches. Determined the items of serology and observe the histological changes of those specimens of liver and femoral head. On clinical study Summarizing and analyzing the lipids in blood. Results: On experimental study: (1)The changes of serology: Compared with the changes of control group in the same time, the experimental group showed elevated serum levels of GGT in the 2nd month, AST in the 3rd month,and ALT in the 6th month were observed. Serum TG increased in the 2nd month,and CHO in the 3rd month in the experimental group. There is an obvious difference of serum level between two groups (P<0.05). (2)The histological changes: In the 3rd, fat bubbles were seen in liver cell in experimental group. The average diameter of the fat cell enlarged obviously in marrow. The nucleus was compressed to one side of osteocyte and became pyknosis. The percentage of empty osteocyte lacuna elevated. On clinical study:The TG in experimental group is higher than control group. Conclusions:There are disorders of lipid metabolism in both the animal models and the patients of alcohol-related osteonecrosis of the femoral head,and alcohol may lead to the osteonecrosis in femoral head.